title: Use of the internet and self-collected samples as a sexually transmissible infection intervention in rural Illinois communities.
abstract: BACKGROUND
  In the USA, reported cases of chlamydia (Chlamydia trachomatis) continue to rise despite substantial funding for screening. National gonorrhoea (Neisseria gonorrhoeae) rates have remained relatively stable, with clusters associated with metropolitan areas. Rural areas are no exception, as every county in Illinois reported cases of chlamydia in 2007. Morbidity associated with infection remains a public health concern, with costs of $US2.5+ billion annually. Novel screening interventions must be examined for their ability to reach those at risk who are missed by traditional methods.
  
  
  METHODS
  The website Iwantthekit.org was modified to allow residents from 25 contiguous counties in Central Illinois to request a self-collected sample kit. Returned kits were tested for chlamydia and gonorrhoea. The initial study period was 12 months.
  
  
  RESULTS
  During the study period, 343 kits were requested from 20 counties and 39.9% were satisfactorily returned for analysis. Positivity rates for chlamydia and gonorrhoea were 5.8% and 1.2%, respectively, for females and 1.9% and 0% for males. Males comprised 37.7% of all internet samples (compared with 23.4% for traditional screening venues) and 40.4% of all internet samples submitted by whites (compared with only 17.2% of traditional screening).
  
  
  CONCLUSIONS
  The female positivity rate was comparable to those seen in other screening venues and the method successfully engaged at-risk males. Overall, participation was low and the costs associated with the program outweighed the averted costs associated with the few cases identified. While this methodology resulted in sample requests from a wide area, it must be utilised by more individuals to become cost-effective.
authors.affiliation: Southern Illinois University School of Medicine, Department of Family and Community Medicine, Springfield, IL 62791-9671, USA. wjenkins@siumed.edu
authors.forename: Wiley D
authors.initials: WD
authors.lastname: Jenkins
authors.forename: Charlie
authors.initials: C
authors.lastname: Rabins
authors.forename: Mathilda
authors.initials: M
authors.lastname: Barnes
authors.forename: Patricia
authors.initials: P
authors.lastname: Agreda
authors.forename: Charlotte
authors.initials: C
authors.lastname: Gaydos
mesh_terms: D002690:Chlamydia Infections / Q000175:diagnosis / Q000382:microbiology; D002692:Chlamydia trachomatis / Q000302:isolation & purification; D005260:Female; D006069:Gonorrhea / Q000175:diagnosis / Q000382:microbiology; D006801:Humans; D007087:Illinois / Q000453:epidemiology; D020407:Internet / Q000706:statistics & numerical data*; D008297:Male; D009344:Neisseria gonorrhoeae / Q000302:isolation & purification; D012424:Rural Population / Q000706:statistics & numerical data*; D012646:Self Administration / Q000706:statistics & numerical data; D016353:Self-Examination / Q000706:statistics & numerical data*; D012749:Sexually Transmitted Diseases / Q000175:diagnosis* / Q000382:microbiology*; D013048:Specimen Handling / Q000706:statistics & numerical data*; D014245:Trichomonas Infections / Q000175:diagnosis / Q000382:microbiology; D014246:Trichomonas vaginalis / Q000302:isolation & purification; D014621:Vagina / Q000382:microbiology; D014626:Vaginal Smears / Q000379:methods